Jennifer E Kim, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LW61102769 Issued in WA

Practice address

7408 N Birch CT
Spokane, WA 99208-9633

Phone

(509) 228-8901

NPI assigned

Feb 10, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 14, 2023 through Dec 14, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Act Services, PLLC

  • Mental Health Counselor
  • Spokane, WA
  • NPI 1568865152
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1760840383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7408 N BIRCH CT",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992089633",
            "telephone_number": "509-228-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7408 N BIRCH CT",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992089633",
            "telephone_number": "509-228-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61102769",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LW61102769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Shepherd Kilpatrick
• John Gauntt Kilpatrick, MSW
• Stephanie L Kilroy, ARNP
• Grace Dylan Kim
• Inah Kim, MD
• John Dexter Kimball III, D.D.S.
• Shireen Najafian Kimbell
• Judy M Kimes, M.S.
• Ann Marie Kimmel
• Amie Raye Kimmerly, D.O.

• Mental Health Counselor in Spokane, WA
• Providers in Spokane, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.